Brain stimulation therapies

2013 ◽  
Author(s):  
Daniel W. O’Connor ◽  
Chris Plakiotis
Keyword(s):  
Cognitive Impairment ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Treatment Of Depression ◽  
Electrical Impulses ◽  
The Brain ◽  
Deep Brain

Electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) all entail the delivery of electrical impulses to the brain with the aim of relieving mental disorders. ECT is an effective treatment of depression, mania and catatonia and, to a lesser extent, of schizophrenia. Its side effects, principally cognitive impairment, are mitigated through the use of individually tailored, unilateral delivery. TMS is more convenient but of lesser effectiveness. DBS, while reversible and thus safer than lesional surgery, is a major undertaking that is reserved at present for profoundly disabling depression, obsessive-compulsive disorder and Tourette’s syndrome.

Neurostimulation therapies

2020 ◽  
pp. 217-232
Author(s):  
Daniel W. O’Connor ◽  
Christos Plakiotis ◽  
Peter Farnbach
Keyword(s):  
Cognitive Impairment ◽  
Deep Brain Stimulation ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Magnetic Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Treatment Of Depression ◽  
Electrical Impulses ◽  
The Brain

Electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) all entail the delivery of electrical impulses to the brain with the aim of relieving mental disorders. ECT is an effective treatment of depression, mania and catatonia and, to a lesser extent, of schizophrenia. Its side effects, principally cognitive impairment, are mitigated through the use of individually tailored, unilateral delivery. TMS is more convenient but of lesser effectiveness. DBS, while reversible and thus safer than lesional surgery, is a major undertaking that is reserved at present for profoundly disabling depression, obsessive-compulsive disorder (OCD), and Tourette’s syndrome.

Deep brain stimulation and anterior capsulotomy: The question of autonomy

2017 ◽  
Vol 41 (S1) ◽  
pp. S323-S323
Author(s):  
S. Raymaekers ◽  
Z. Van Duppen ◽  
K. Demyttenaere ◽  
L. Luyten ◽  
L. Gabriels ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Well Being ◽  
Structured Interviews ◽  
Obsessive Compulsive ◽  
Research Education ◽  
Compulsive Disorder ◽  
The Brain ◽  
Anterior Capsulotomy ◽  
Deep Brain

IntroductionIn carefully selected treatment-refractory patients with obsessive compulsive disorder (OCD), deep brain stimulation (DBS) or anterior capsulotomy (AC) might be considered as a possible treatment. However, the direct intervention in the brain can raise questions about autonomy. Do patients still feel like they are in control of their actions when their behavior is changed by a surgical intervention?Objective/aimsTo examine in both AC and DBS patients whether these intervention influenced perception of autonomy. We aimed to discover any differences in these perceptions when comparing AC and DBS patients.MethodsWe conducted semi-structured interviews with AC and DBS patients. Interviews were recorded digitally and transcribed verbatim. We analyzed interviews in an iterative process based on grounded theory principles.ResultsWe interviewed 10 DBS patients and 6 AC patients. Sense of agency (the awareness that one is the author of his/her own actions) did not seem to be diminished by AC or DBS. However, especially DBS patients are aware of their dependency on a device for their well-being. Another important theme is authenticity (in how far patients perceive their actions and thoughts as matching their self-concept). Feelings of authenticity can be disturbed especially in cases of induced hypomania (for DBS) or apathy (for AC). OCD itself also has an impact on autonomy as patients describe a lack of freedom due to their disorder.ConclusionDespite extensive changes in emotions, behavior and even personal identity after DBS or AC surgery, perceived autonomy was not greatly altered in these OCD patients.Disclosure of interestMedtronic provided grants for research, education, and traveling to B. Nuttin and L. Gabriëls, who hold the Medtronic Chair for Stereotactic Neurosurgery in Psychiatric Disorders at KU Leuven. S. Raymaekers is supported by this Chair. B. Nuttin co-owns a patent on DBS in OCD.

scholarly journals Deep brain stimulation. How it controls movements in Parkinson’s disease?

2019 ◽  
Vol 21 (3) ◽  
pp. 93-99
Author(s):  
Z. A. Zalyalova
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Treatment Rate ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Pain Syndromes ◽  
The Brain ◽  
Deep Brain

Deep brain stimulation (DBS) involves implantation of electrodes in the basal ganglia of the brain. Dysregulation of neuronal activity in these structures is the cause of motor disorders. DBS is used in many motor (Parkinson’s disease, essential tremor, dystonia, ticks, tardive dyskinesia and others), psychological, behavioral and affective (depression, obsessive-compulsive disorder, epilepsy and others) disorders, as well as in severe pain syndromes resistant to drug therapy. However, the mechanisms of action of DBS are not fully understood. Currently, different theories and hypotheses are considered which explain its mechanism of treatment: rate model, “jamming” theory, hypotheses about the effect on neurogenesis, astrocyte activity, increased brain circulation, electrotaxis, etc.

scholarly journals A randomised, double-blind, sham-controlled trial of deep brain stimulation of the bed nucleus of the stria terminalis for treatment-resistant obsessive-compulsive disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Philip E. Mosley ◽  
François Windels ◽  
John Morris ◽  
Terry Coyne ◽  
Rodney Marsh ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Adverse Events ◽  
Brain Stimulation ◽  
Stria Terminalis ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Bed Nucleus ◽  
Compulsive Disorder ◽  
Deep Brain

AbstractDeep brain stimulation (DBS) is a promising treatment for severe, treatment-resistant obsessive-compulsive disorder (OCD). Here, nine participants (four females, mean age 47.9 ± 10.7 years) were implanted with DBS electrodes bilaterally in the bed nucleus of the stria terminalis (BNST). Following a one-month postoperative recovery phase, participants entered a three-month randomised, double-blind, sham-controlled phase before a twelve-month period of open-label stimulation incorporating a course of cognitive behavioural therapy (CBT). The primary outcome measure was OCD symptoms as rated with the Yale-Brown Obsessive-Compulsive Scale (YBOCS). In the blinded phase, there was a significant benefit of active stimulation over sham (p = 0.025, mean difference 4.9 points). After the open phase, the mean reduction in YBOCS was 16.6 ± 1.9 points (χ2 (11) = 39.8, p = 3.8 × 10−5), with seven participants classified as responders. CBT resulted in an additive YBOCS reduction of 4.8 ± 3.9 points (p = 0.011). There were two serious adverse events related to the DBS device, the most severe of which was an infection during the open phase necessitating device explantation. There were no serious psychiatric adverse events related to stimulation. An analysis of the structural connectivity of each participant’s individualised stimulation field isolated right-hemispheric fibres associated with YBOCS reduction. These included subcortical tracts incorporating the amygdala, hippocampus and stria terminalis, in addition to cortical regions in the ventrolateral and ventromedial prefrontal cortex, parahippocampal, parietal and extrastriate visual cortex. In conclusion, this study provides further evidence supporting the efficacy and tolerability of DBS in the region of the BNST for individuals with otherwise treatment-refractory OCD and identifies a connectivity fingerprint associated with clinical benefit.

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